Minimally invasive direct coronary artery bypass using H graft for pleuralsymphysis

In November 1995, video-assisted minimally invasive direct coronary artery bypass procedure, which is defined as a combination of the thoracoscopic in ternal mammary artery (IMA) harvest and direct coronary bypass grafting, wa s introduced for patients who need minimally invasive direct coronary arter y bypass (MIDCAB) using IMA. In the thoracoscopic IMA harvest, the pleural adhesions or symphysis present an obstacle. We present a case where a redo patient who had complete pleural symphysis of left chest cavity precluded t he thoracoscopic IMA harvest, and MIDCAB with the H graft procedure was per formed. (C) 1999 by The Society of Thoracic Surgeons.